New report details WHO efforts to eliminate malaria in the Greater Mekong Subregion

The World Health Organization (WHO) recently released a report "Eliminating malaria in the Greater Mekong Subregion" which suggests tried and tested approaches to end the transmission of the Plasmodium falciparum malaria infection across Southeast Asia. The report confirms a major decline in the number of cases and deaths associated with malaria over the past three years. The report estimates that the six countries within the Greater Mekong Subregion (GMS) reduced the malaria case incidence by an estimated 54% between 2012 and 2015; deaths were estimated to have fallen by 84% over the same period.

The key objectives of the report include:

• Interrupt transmission of P. falciparum in areas of multidrug resistance, including artemisinin-based combination therapy (ACT) resistance, by no later than 2020, and in all areas of the GMS by 2025
• Reduce malaria in all high-transmission areas to less than 1 case per 1000 population at risk and initiate elimination activities by 2020
• Prevent the reintroduction of malaria in areas where it has been interrupted.

With technical support from the WHO and partners, all GMS countries have developed malaria elimination action plans. The WHO will provide ongoing support for country elimination efforts through the Mekong Malaria Elimination (MME) project.

The GMS region has come very close to eliminating falciparum malaria across the region. However, as the case load decreases, the threat of further resistance to artemisinin derivatives and other partner drugs increases. Further emergence or spread of antimalarial drug resistance in the region could potentially undermine the recent gains.

In view of the rapidly changing malaria landscape, WHO’s Malaria Policy and Advisory Committee (MPAC), a group of leading malaria experts, agreed in 2014 that there was only one way forward: eliminating the disease altogether from the subregion.

A recent editorial article entitled 'Securing gains in uncertain times', published by the Lancet Infectious Diseases, concludes, "The announcement of this initiative left no doubt as to the sense of urgency in tackling the risks posed by drug resistance in this region—the danger posed by widespread resistance to these drugs cannot be overemphasised."

Read more on the report.